A formal approach to clinical decision making and patient management

PROforma is a language for defining clinical procedures. The language embodies a general methodology for specifying procedures such as therapeutic protocols and guidelines, and provides notations for detailing the medical knowledge and patient data associated with clinical decisions, actions etc. Once a procedure has been represented in the language it can be used in various ways. It can be reviewed by specialist clinicians and scientists to ensure that it captures 'best clinical practice', disseminated electronically as a source of up to date reference material, and interpreted by a computer in order to assist medical staff in complying with the procedure. PROforma applications can support a range of clinical tasks, such as decision making, scheduling of actions over time, reminders for patient data collection, monitoring adverse events, and so on. We outline the PROforma development method together with a description of the PROforma language. It is currently being assessed by medical and technical professionals who are interested in building computer systems to support patient care, in the expectation of revising the language to reflect this assessment.